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NBCE Part II/III > NMS DX > Flashcards

NMS DX Flashcards

1
Q

Pneumonic for Cranial Nerves - sensory or motor:

A 
Some 
Say
Marry 
Money
But
My 
Brother
Says 
Big 
Boobs 
Matter 
Most
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2
Q

R Corneal Reflex

A

A: 5 (trig)
Int: Pons
E: 7 (fac)

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3
Q

R Pharyngeal (Gag)

A

A: 9 (glos)
Int: Medulla
E: 10 (vag)

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4
Q

R Palateal (Uvular)

A

A: 9 (glos)
Int: Medulla
E: 10 (vag)

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5
Q

R Interscapular

A

A: T2-T7 spinal n
Int: T2-T7 spinal cord
E: Dorsal scapular n

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6
Q

R Abdominal

A

A: Up: T7-10, Lo: T11-12
Int: SC T7-T12
E: T7-10, Lo: T11-12

** NORMAL: umbilicus moves toward side stroked

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7
Q

R Plantar

A

A: Tibial n.
Int: SC S1-2
E: Tibial n.

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8
Q

R Direct Light

A

A: 2 (optic) ips
Int: midbrain
E: 3 (occu) ips

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9
Q

R Indirect Light

A

A: 2 (optic) ips
Int: midbrain
E: 3 (occu) contra

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10
Q

R Accomodation

A

A: 2
Int: occipital cortex
E: 3

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11
Q

R Carotid Sinus

A

A: 9 (glos)
Int: medulla
E: 10 (vag)

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12
Q

R Occulocardiac

A

A: 5 (trig)
Int: Medulla
E: 10 (vag)

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13
Q

R Ciliospinal

A

A: cervical symp chain
Int: T1-T2 spinal cord
E: cervical symp chain

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14
Q

Trigeminal Neuraliga

A

aka Tic Douloureaux

Burning on the face in multiple episodes on jaw or cheek, unilateral

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15
Q

Cardinal Fields of Gaze

A

S0-4 LR-6 / 3

Superior Oblique = down and in

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16
Q

Parasympathetic of Occulomoter N

A 
Ciliary muscles (lens shape)
Constrictor papillae
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17
Q

Bells Palsy

A 
CN 7 (Facial)
Ipsilateral facial paralysis - impermanent
Can NOT raise eyebrows

**DDX from Stroke (bilateral, forehead wrinkles)

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18
Q

Cervical Dystonia

A

AKAs: Torticollis, Wry Neck

  • spasm of SCM
  • CN 11 lesion
  • ipsilateral = lateral flexion, contralateral = rotation
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19
Q

Westphal Sign

A

DTR absence

– Jendrassik Man = distractor to help

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20
Q

Wexler Scale

A 
0 = absent with reinforcement
1+ Hypoactive with no reinforcement or normal with reinforcement -- LMNL
2+ normal
3+ hyperactive -- UMNL
4+ hyperactive w/ transient clonus
5* hyperactive w/ sustained clonus
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21
Q

Jaw Jerk DTR

A

Trigeminal (CN 5)

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22
Q

Patellar DTR

A

Femoral L4

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23
Q

Medial Hamstring DTR

A

Sciatic L5

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24
Q

Achilles

A

Tibial S1

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25
Q

Cremasteric

A

Male
A: Femoral N.
E: Genitofemoral N.

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26
Q

Geigel’s

A

Female
A: Femoral N.
E: Genitofemoral N.

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27
Q

Beevors

A

A: Up: T7-10, Lo: T11-12
Int: SC T7-T12
E: T7-10, Lo: T11-12

**Normal: Umbilicus stays midline; Pathological: Umbilicus moves away from lesion

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28
Q

UMNL

A 
spastic paralysis
hyperactive DTR
pathological reflexes
clonus
hypertonic
no superficial reflexes
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29
Q

LMNL

A 
** CN or Nerve Root **
flaccid paralysis
hypoactive / absent DTR
hypotonic
degeneration / atrophy
fasiculations 
no superficial reflexes
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30
Q

PR Gordon’s

A

Squeeze calf below knee

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31
Q

PR Schaefer

A

Squeeze achilles

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32
Q

PR Rossolimo

A

Tap ball of foot

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33
Q

PR Gordon’s finger

A

strokes pisiform

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34
Q

PR Chaddocks wrist

A

strokes distal ulnar side of forearm near wrist

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35
Q

Muscle Grading

A 
5 = Normal: ROM against gravity w/ resistance
4 = Good: ROM against gravity w/ SOME resistance
3 = Fair: ROM against gravity 
2 = Poor: ROM no gravity
1 = Trace: no motion, slight contractility
0 = Zero: none
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36
Q

Erb’s Palsy

A

C5,C6 – radial n entrapment, too

Waiter’s Tip Deformity: ADDUCTION + INTERNAL ROTATION + WRIST FLEXION

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37
Q

Wrist Drop

A

C7 – radial n entrapment, too

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38
Q

Klumpke’s Paralysis

A

C8-T1 – lower brachial plexus palsy from childbirth

clas hand deformity with wrist flexion

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39
Q

Meralgia Paresthetica

A

L1-L3

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40
Q

Foot Drop

A

L4-5

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41
Q

Cauda Equina

A

S2-4

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42
Q

NR L1-L3

A

M: Hip flexion
Muscle: Psoas
S: Inguinal Lig, Oblique, Oblique Across

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43
Q

NR L2-L4

A

M: Hip flexion
Muscle: quads + add

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44
Q

NR T5-12

A

M: Trunk flexion
Muscle: REctus Abdominus
S: T5-T12

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45
Q

Axillary N.

A

M: Arm ABduc
Muscle: Deltoid + Teres Minor
S: Lateral arm
Disorder: GH dislocation

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46
Q

Radial N.

A

M: Wrist/Finger Extension + Thumb Abd
Muscle: Wrist/Finger extensors + Triceps
S: dorsal web b/w thumb and index
Disorder: Wrist Drop, Crutch Palsy, Erbs Palsy

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47
Q

Musculocutaneous N.

A

M: elbow flexion
Muscle: biceps, brachialis, coracobrachialis
S: lateral forearm
Disorder: impingement

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48
Q

Median N.

A

M: pincher grip, thumb opposition
Muscle: wrist/thumb flexors, thenar, thumb abd
S: distal radial hand, 2nd digit
Disorder: carpal tunnel, pronator teres, ape hand

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49
Q

Ulnar N.

A

M: pinky + thumb adduction
Muscle: finger ab/add + thumb add
S: distal ulnar hand, 5th digit
Disorder: Claw hand

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50
Q

Dorsal Scapular N.

A

M: elevate + retract scap
Muscle: rhomboids + lev scap
S:
Disorder: Flaring of Scap

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51
Q

Lateral Femoral Cutaneous N.

A

Lateral Thigh –> Meralgia Paresthetica

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52
Q

Saphenous N.

A

Anteromedial knee + Medial Leg

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53
Q

Obturator N.

A

M: Hip Adduction
Muscle: Hip Adductor muscles
S: Medial thigh
Disorder: Impingement

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54
Q

Femoral N.

A

M: Hip flexion, Knee extension
Muscle: Psoas + Quads
S: Anteromedial thigh + leg
Disorder: Impingement

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55
Q

Sciatic N.

A

M: Knee Flexion
Muscle: Hamstrings
S:Ant/Post Leg, Sole/Dorsum of foot
Disorder: Piriformis Syndrome

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56
Q

Peroneal N.

A

M: Foot Dorsiflexion / Inv / Ev
Muscle: Tib Ant, Toe extens, peroneals
S: Anterior Leg + Dorsum of Foot
Disorder: Fib Head Fx

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57
Q

Medial Plantar N.

A

M: Toe flexion
Muscle: Toe flexor muscles
S:
Disorder: Tarsal Tunnel Syndrome

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58
Q

Peripheral Nerve Entrapments:

A

DR CUMA

Drop Wrist
Radial N.
Claw Hand (aka pope hand)
Ulnar N. 
Median N. 
Ape Hand (thenar atrophy)
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59
Q

Dermatogenous

A

Sensory distribution of a Nerve Root

60
Q

Myotogenous

61
Q

Scleratogenous

A

Facet / Joints — embryological sclerotomes

62
Q

Radicular

A

Dermatome of a nerve root

63
Q

Referred

A

Along scleroderm origination…share a pathway

64
Q 
Types of pain for: 
Muscle
Nerve
Circulation
Bone Cx
Scleratogenous
Myofascial
A

Muscle - cramping / spasm / ache / dull
Nerve - shooting / radiating / burning
Circulation - THROBBING / PULSATING
Bone Cx - CONSTANT / DEEP / BORING / NOCTURNAL
Scleratogenous - poorly localized / dull ache
Myofascial - trigger points

65
Q 
Referred  Pain Sites: 
Gallbladder
Pancreas
Heart
Intestines
Appendix
Kidney
Ureter
Bladder
A 
Gallbladder: RT shoulder + Inf Scap
Pancreas - T10 epigastric 
Heart - LF shoulder + med LF arm
Intestines - periumbilical 
Appendix - early = epigastric; late = RLQ
Kidney - flank
Ureter - groin
Bladder -  suprapubic area
66
Q

3 Night Pains

A

C’s

  • Cancer
  • Carpal Tunnel
  • Cluster Headache
67
Q

Carpal Tunnel Syndrome

A 
Median N (1st 3 digits) 
Flexor Retinaculum 
Cause: fluid retention due to pregnancy
Thenar atrophy + Ape Hand (weak opp poll)
Nocturnal Pain 
Adjust Lunate 
Grip strength (ONLY med n)
68
Q

Pronator Teres Syndrome

A 
Median N (1st 3 digits)
--> Ant Inteross N. 
Heads of pronator teres
MOI: carpenter / mechanic (MALE)
Grip strength (ONLY med n)
69
Q

Ulnar N Entrapment

A

1) Tunnel of Guyon (Pisi + H.Hamate)
2) Cubital Tunnel
Cyclist
Claw Hand deformity
Weak add poll + hypothenar atrophy
Weak wrist flexion on ulnar side

70
Q

Radial N Entrapment

A

Wrist drop + Erb’s Palsy + Saturday Night Palsy + Crutch Palsy
Location = spiral groove
LEAD TOXICITY
no triceps reflex

71
Q

Long Thoracic N. Entrapment

A

Scapula Winging
Serateous Anterior
“SALT your Wings”

72
Q

Dorsal Scapular N. Entrapment

A

Scapular Flaring

Rhomboid mm paralysis

73
Q

Lateral Femoral Cutaneous N. Entrapment

A

Meralgia Paresthetica
Site: PELVIC BRIM UNDER INGUINAL LIGAMENT
Burning on antero-lateral thigh (ddx nerve root)
Obese + tight jenes + cop

74
Q

Sciatic N. Entrapment

A

Site: pelvis, hip, popliteal fossa
pain in - post butt, thigh, leg down to floor
Weak knee flexion
Achilles reflex is weak

75
Q

Tibial N. Entrapment

A

Tarsal Tunnel Syndrome (Medial Plantar N)
Unilateral BURNING PARESTHESIA on bottom of feet
MOI: inversion ankle sprain jamming medial side

76
Q

Morton’s Neuroma

A

3rd and 4th MTs
Narrow toes shoes
Mortons Squeeze

77
Q

Common Peroneal N. Entrapment

A

Site: Fib Head
Lateral leg pain + weak peroneal mm
FOOT DROP

78
Q

Deep Peroneal N.

A 
Anterior Compartment Syndrome = FOOT DROP
Can affect any of the 4 compartments:
1 Tib Ant
2 Ext Hall Long
3 Ext Dig Long
4 Per Tertius
79
Q

Mallet Finger

A

Fingertip curled from injury

80
Q

Swan Neck Deformity

A

PIP: hyperEXT
DIP: hyperFLEX
RA!!!

81
Q

Boutonniere Deformity

A

PIP:hyperFLEX
DIP: hyperEXT
RA!!!

82
Q

Dupuytren’s Contracture

A

ABNORMAL THICKENING underneath palm and fingers (not there = ulnar n. lesion)
last 2 fingers curl into palm

83
Q

Trigger Finger

A

finger locked in flexed position

84
Q

De Queervains Disease

A

Inflammation of EXTENSOR POLLICIS BREVIS + ABDUCTOR POLLICIS LONGUS
Finklesteins

85
Q

Syringomyyelia

A

loss of pain and temp on shoulders and back in CAPE LIKE DISTRIBUTION (SHAW LIKE)

86
Q

MS (multiple sclerosis)

A 
Female 30s
Demyelination of CNS
Gets better, than worse, better, than worse 
optic neuritis causing transient blindness
Leg UPMNL --> distal weakness 
(+) LHERMITTE'S TEST
Heat = contra-indicated 
CHARCOT'S TRIAD = ITs a SIN to have MS!!
- S = scanning speech
- I = intention tremors
- N = nystagmus
87
Q

Myasthenia Gravis

A

Female 30s
Autoimmune - antibodies against ACh receptors = myoneural junction dysfunction
Muscle weakness at END OF DAY or post exercise

88
Q

ALS

A 
Aka Lou Gehrigs Disease
Male 60s
LMNL in arms + UMNL in legs 
MOTOR ONLY!!!!!!
Usually begins in hands and feet, life expectancy short
Corticospinal tract + anterior horn
89
Q

PLS

A 
Combined Systems Disease 
Glove + Stocking Paresthesia 
(+) SCHILLING TEST!!
Symptoms irreversible 
Cause: B12 Deficiency (pernicious anemia)
90
Q

Brown Sequard

A

Same side MOTOR FUNCTION loss

Opp side PAIN/TEMP loss

91
Q

Cerebral Palsy

A

Anoxia to brain
SCISSOR GAIT – legs cross midline
Athetoid = MC

92
Q

Paralysis Agitans

A 
Parkinsons Disease
1) Fenestrating Gait 2) Shuffling Gait 3) Propulsive Gait
RESTING TREMORS
FORWARD STOOPED POSTURE
MASKED FACE
93
Q

Guillian-Barre Syndrome

A

PNS inflammatory polyneuropathy!!
Linked to recent IMMUNIZATIONS or POST FLU INFECTION
Ascending Paralysis – can be dangerous if reaches diaphragm

94
Q

Tabes Dorsalis

A

Teritiary Syphillis
SLAPPAGE GAIT
Pupil irregularities

95
Q

Muscular Dystrophy

A 
Erb Duchenne 
BOYS 3-7
WADDLING GAIT
PSEUDO-HYPERTROPHY OF CALVES/DELTOIDS
GOWERS SIGN
Increase in CPK, Decrease creatinine
96
Q

Charcot Marie Tooth Disease

A

Hereditary affecting motor and sensory
Foot drop + High-stepped gait
Hammer toes

97
Q

Hungingtons Chorea

A

MC age of onset 35-44

Neurodegenerative Genetic Disorder

98
Q

Gait Cycle

A

STANCE = 60%

  • Heel Strike
  • Foot Strike
  • Toe Off

SWING = 40%

99
Q

Acceleration of Gait

A

Psoas + Rectus Femoris

100
Q

Deceleration of Gait

A

Hamstrings ECCENTRICALLY contracting

101
Q

Heel Strike of Gait

A

Dorsiflexors ECCENTRICALLY contrct

Quadriceps ECCENTRICALLY contract

102
Q

Foot Strike of Gait

A 
Abductors hold body up
Plantar Flexors (gastroc, soleus, plantaris = triceps surae) contract to push body ahead
103
Q

Toe Off of Gait

A

Quadriceps CONCENTRICALLY contract to help plantar flexors push body forward

104
Q

Waddling Gait

A

Muscular Dystrophy

105
Q

Propulsion Gait

A

Parkinsons

106
Q

Festinating Gait

A

Parkinsons

107
Q

Shuffling Gait

A

Parkinsons

108
Q

Steppage Gait

A

Anterior Compartment Syndrome = Foot Drop

109
Q

Trendelenburg

A

Weak glut med

110
Q

Slappage Gait

A

Posterior Column Disease = TABES DORSALIS

111
Q

Circumduction Gait

112
Q

Spastic Gait

113
Q

Antalgic Gait

A

avoidance of pain

114
Q

Drunken / MOtor Gait

A

Cerebellum problem – wide based gait

115
Q

Rotator Cuff Tear

A 
MC = supraspinatus MC 
DX = MRI
116
Q

Rotator Cuff Muscles

A

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

117
Q

Rotator MM: Supraspinatus

A

ABduction
Suprascapular N
GT insertion

118
Q

Rotator MM: Infraspinatus

A

EX ROT
Suprascapular N
GT insertion

119
Q

Rotator MM: Teres Minor

A

EX ROT
Axillary N.
GT insertion

120
Q

Rotator MM: Subscapularis

A

IN ROT
Subscapular N.
LESSER TUBERCLE INSERTION!!

121
Q

Scapular Motion

A

Elevation: Trap + Lev Scap
Retraction: Rhomboids (Maj + Min)
Protraction: Serratus Anterior

122
Q

Test for Subclavian Artery + Scalenus Medius Syndrome

A

Modified Adsons

123
Q

Test for Cervical Rib

A

Adsons (Scalenus Anticus)

Halsteads

124
Q

Test for compression of 1st rib + clavicle

A

Edens or Costoclavicular

125
Q

Test for pec minor syndrome or Axillary A compression

A

Wrights or Hyperabduction Maneuver

126
Q

Test for TOS

A

Roos

Bikele’s

127
Q

Ortolanis

A

baby legs ABducted + Externally rotated

CHD

128
Q

Barlows

A

baby legs ADDucted

129
Q

Ligament Tear

A

Immediate swelling = Intra Articular

130
Q

Meniscus Tear

A

Swelling 12-24 hours; unable to lock out

Joint Line

131
Q

Chondromalacia Patella

A

Runners Kne
Walking downstairs = PAIN
Tests: Clark + Fouchets

132
Q

Jumpers Knee

A

Patellar tendonitis

133
Q

Housemaids Knee

A

Prepatellar Bursitis

134
Q

TFL Syndrome

A

shortened TFL

running, up/down stairs/hills = PAIN

135
Q

Pes Planus

136
Q

Talipes Equinovarus

A

MC birth defect
clubfoot
heel elevated, foot inward

137
Q

Pes Cavus

A

high arch

March fx = common

138
Q

Metatarsal Stress FX

139
Q

Sprain / Strain grading

A

1 no tear..slight swelling and loss of motion
2 partial tear…swelling + brusing…no motion
3 complete tear

140
Q

Burn Bench Test

A

Malingering Test

141
Q

Lasegue’s Sitting

A

Malingering Test

..negative yet + with normal SLR

142
Q

Magnussons

A

Malingering Test

different points

143
Q

Mannkopfs Sign

A

If patient’s pulse increases when applying pressure to painful spot, they are NOT malingering

144
Q

AS tests

A

Chest Expansion Test
Forrestier Bowstring Sign
Lewin Supine Test
Amoss Sign

145
Q

Libman

A

test for patient’s pain threshold

146
Q

Rust Sign

A

graps head upon sitting from recumbent position

–> cervical instability, RA

147
Q

Dejerine’s Triad

A

Space occupying lesion

coughing, sneezing, straining

NBCE Part II/III (6 decks)

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